Effects of air pollution on the incidence of myocardial infarction

Abstract

Context: Short-term fluctuations in air pollution have been associated with changes in both overall and cardiovascular mortality. Objective: To consider the effects of air pollution on myocardial infarction (MI) risk by systematically reviewing studies looking at this specific outcome. Data sources: Medline, Embase and TOXNET publication databases, as well as reference lists and the websites of relevant public organisations. Study selection: Studies presenting original data with MI as a specific outcome and one or more of the following as an exposure of interest were included: particulate matter (PM), black carbon/black smoke, ozone, carbon monoxide, nitrogen oxides, sulphur dioxide and traffic exposure. Data extraction: The effects of each pollutant on risk of MI, including effect sizes and confidence intervals, were recorded where possible. Methodological details were also extracted including study population, location and setting, ascertainment of MI events, adjustment for potential confounders and consideration of lagged effects. Results: 26 studies were identified: 19 looked at the shortterm effects of pollution on a daily timescale; the remaining 7 at longer-term effects. A proportion of studies reported statistically significant detrimental effects of PM with diameter ,2.5 mm (3/5 studies, risk increase estimates ranging from 5 to 17% per 10 mg/m 3 increase), PM ,10 mm (3/10, 0.7-11% per 10 mg/m 3 ), CO (6/14, 2-4% per ppm), SO 2 (6/13, effect estimates on varied scales) and NO 2 (6/13, 1-9% per 10 ppb). Increasing ozone levels were associated with a reduction in MI risk in 3/12 studies. A number of differences in location, population and demographics and study methodology between studies were identified that might have affected results. Conclusion: There is some evidence that short-term fluctuations in air pollution affect the risk of MI. However, further studies are needed to clarify the nature of these effects and identify vulnerable populations and individuals.

Short term effects of temperature on risk of myocardial infarction in England and Wales: time series regression analysis of the Myocardial Ischaemia National Audit Project (MINAP) registry

“…The smoothness of a spline is a function of the number of degrees of freedom; we chose seven degrees of freedom per calendar year in keeping with previous studies, as a compromise between providing adequate control for unmeasured confounders and leaving sufficient information from which to estimate temperature effects. 12 13 We adjusted the model for day of the week and public holidays, levels of influenza and respiratory syncytial viruses (three categories representing 0, 1, or ≥2 laboratory confirmed cases in the particular conurbation), and PM10 and ozone levels (each modelled at lag days 0-3 inclusive as there seems to be little evidence of pollution effects at longer lags 14 ). We also controlled for daily relative humidity (average of the current and previous three days) using a four knot natural cubic spline to allow for non-linearity.…”

Independent and combined interaction of fine particulate matter in atmospheric air and the frequency of acute myocardial infarction hospitalizations in Varna, Bulgaria

“…Odds ratio for AMI in people working in hypokinetic state, according to the mean 24-hour value of FPM 10 at the point of "Ian Palach St." in an independent, combined with ozone and sulfur dioxide, and with relative humidity action. [5] and the mortality rate, including respiratory [2] and cardiovascular mortality [19]. However, the relationship between atmospheric pollution and short-term risk of AMI is still under discussion.…”

“…In developed countries, cardiovascular diseases are a leading cause of death and are also related to high incidence of morbidity [18,19]. These countries have high levels of pollution.…”

PM10 Air Pollution and Acute Hospital Admissions for Cardiovascular and Respiratory Causes in Ostrava

“…The average daily numbers of hospital admissions were calculated for the PM 10 concentration intervals (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in the range from 0-150 μg.m −3 .…”

“…According to recent findings, the short-term exposure to fractions PM 10 and PM 2.5 are associated with an increased mortality and morbidity (PM 10 exposure is associated with morbidity for respiratory causes, PM 2.5 exposure is related to cardiovascular morbidity and mortality) (8)(9)(10). American studies have evaluated the mortality and morbidity related to PM 2.5 for more than a decade.…”